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Meniscal tear

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The meniscus is a semilunar-shaped fibrocartilagenous structure interposed between the femoral condyles and tibial plateaux.

  • lateral meniscus is a “C” shaped structure with a short distance between its anterior and posterior horns while the medial meniscus is “U” shaped and with a larger distance between the two horns
  • it is mostly avascular in adults (1)
  • the menisci is responsible in transmiting more than 50% of body weight in extension, and even more in flexion. This quality of mensici helps in
    • distribution of stresses over the articular cartilage
    • absorption of shock during axial loading
    • stabilization of the joint in both flexion and extension
    • joint lubrication (2)

Aetiology of meniscal tears can be divided into two groups

  • increased force on a normal meniscus
    • usually results from a twisting strain applied to a flexed, weight-bearing leg during sport
    • produces longitudinal or radial tears
  • normal forces on a degenerative meniscus
    • usually results in horizontal tears in the posterior half of the meniscus (2)

A torn portion of meniscus may sometimes displace and become jammed between the femur and tibia in the centre of the joint - a 'bucket handle tear'. This may cause a blocking of extension - 'locking of the knee'.

The meniscal tag will act as a persistent mechanical irritant, and will cause recurrent synovial effusion and eventually, secondary osteoarthritis. Medial meniscal tears produce prolonged loss of extension that can stretch and rupture the anterior cruciate ligament.

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